HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l�
Date: Permit Number: (609 -008(o 1 6 09 -008(o
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
;P, OPQSED IM`PRQ1lEMENT
Address: 8255 Sandpine Cir
Legal Description: LAKE LUCIE ESTATES PLAT NO. ONE LOT 91
Property Tax ID#: 3426-703-0105-000-1 Lot No.91
Site Plan Name: Dominick Pollari Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
IX
DETAILED DE CRIPTION C)F WORK r '3
Install 12 Accordion Shutters
4_ JNST,RUCTI(7N OR ,N 3 ' ., ....
Additional work to be e orme under this permit—c ec a appy:
❑HVAC E]Gas Tank Gas Piping Shutters ❑Windows/Doors
❑Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5816.00 Utilities:cn Sewer Septic Building Height:
IUiER/LESEE ab COIUTRAGTOR {; p.
Name Dominick Pollari Name: Michael Heissenberg
Address:8255 Sandpine Cir Company: Expert Shutters
City: Port St Lucie State:FL Address: 668 SW Whitmore
Zip Code: 34952 Fax: City: Port St Lucie State:FL
Phone No.772-332-2373 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
5t1P�LEMENT,4L CONSTRICTION LIED LAW INFC}RMATIQN�
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: waiterTillit Name:
Address:6355 Nw 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-871-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or_recctrdtDg,,your Nenje of Commencement.
s
_Signature of Owner/Lessee/Agent Signatu of Contractor/License H Ider
STATE OF FLORIDA l ���)°� COUNTY OF ORIDA
COUNTY OF T ��• �U C!
The forgoing instrument was acknowledge�lbefore me The forging instrument was acknowledge before me
this G` �'dayof 201C by this
�i' day of Ltd `1 20 by
Michael HeissenbErg Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging).
(Signature of Notary P lic-State of
I i ) (Signature of Nota7Pu ic-State of FI i a
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
��1�p1�0� EATHER VIZZO l '��UaUb ptP�YAs HEATHER VIZZO
Commission �ot�v al Commission sow( ARY PUBLIC
NOTARY PUBLIC c
Q`� x
!-:STATE OF FLORIDA
-STATE OF FLORID 9
W si Comm#FF176266 `r�RE Ask' Expires 11/13/2018
Revised 07/15/2014 *CEjs Expires 11/13/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS